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I\4AYOR lvliguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILI\,lEIVBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas CITY MANAGER Raul Godinez ll CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNINC & BUILDING AGENCY 20 Civic Center Plaza P.O. 8ox 1988 . Santa Ana, California 92702 www.santa-ana.orglpba NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at A.270'7r We are providing you with an Owner-Builder Acknowledqment and lnformation Verification Form to make you aware of your responsibiliiies and possible risk you may incur by having this permit issued in your names as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFI CATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understa nd or verify this information. L@: I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" Effiing permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an Owner-Bullder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to on my property 2. I understand building permits are not required to be signed by property owners unless they are responsible for nstruction and are not hiring a licensed Contractor to assume this responsibility 3. lunderstand as an "Owner-Buildei' I am the responsible party of record onthe permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instpad of my own. ILO I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. Efu_5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the -io-tal value of my construction is at least five hundred doltars ($500), including labor and materials, I may be considered an ployer" under state and federal law the e 6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide wo unemployment compensation of each "employee." I al rkers' compensation disability insurance, and contribute to so understand my failure to abide by these laws may subject me to SE us financial risk reside 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family ntial structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by SANTA ANA CITY COUNCIL moulido@sanl8-ana oro Mayor Pro Tem, Ward 2 mimaninez@sanla-ana.o.o vsarm e.to@santa -a na.oro solodo@saiia ans.oro P. Davd Benavdes dbenavides@sanla-a.a.o.o ivilleoas@santa-ana.oro stina1610@sa.ta-ana oro